Application of a Novel Severity Grading System for Surgical Complications after Colorectal Resection

BACKGROUND: Uniform and accurate reporting of surgical complications is the basis for quality control. We developed a computerized system for reporting and grading Surgical complications in colorectal surgery. This study was conducted to evaluate this computerized reporting system. STUDY DESIGN: A retrospective chart review was conducted of all surgical complications in patients who underwent resection of the colon or rectum at our institution between the years 1999 and 2004 (n 408). All complications were recorded using the computerized reporting system and compared with complications reported in the literature. RESULTS: Elective operations were performed in 75.7% of patients, and 24.3% required emergency operations. Of the 408 patients in the study, 239 (58.6%) had an uneventful recovery without complications. At least I complication was recorded in 169 (41.4%) patients. Grades I and 2 complications were recorded in 83 (20.3%) and 105 (25.7%) patients, respectively, requiring observation or medical treatment only, and 59 patients (14.5%) had grades 3 to 5 complications. The three leading complications were surgical site infection, intraabdominal abscess, and hemorrhage requiring blood transfusion. The grades 3 to 5 complication rate was within the range described in the literature, and the rate of grades 1 and 2 complications was Substantially higher. These grades I and 2 complications were associated with a substantially longer hospital stay. CONCLUSIONS: This novel complication reporting system was found feasible and proved to have a higher sensitivity for recording minor but Meaningful complications that tend to prolong hospital stay. (J Am Coll Surg 2009;208:355-361. (C) 2009 by the American College of Surgeons)